Assessing Communication Function in Children - PowerPoint Presentation

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Assessing Communication Function in ChildrenCaroline Viney – Specialist SLT

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Outcomes of learningTo develop a better understanding of how communication develops at different stages and ages

To understand the building blocks of communication

To know the difference between a language/communication delay and a developmental disorder

To be more confident gathering information where communication is a concern

To consider how communication and language impacts on the teams formulation of a child’s difficultiesTo consider how a child’s communication needs impacts on how clinical interventions are delivered.

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Communication skills are the foundation of children’s intellectual, social and emotional development. Spoken language is the key medium for learning and language development is accepted as being critical to cognitive development.

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What is Communication?

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What is communication?Exchanging information for a specific purpose using verbal, non-verbal or written means

Verbal

Words, sentences

Vocalisations

Tone of voice

Stress

Pitch

volume

Non-verbal

Eye contact

Facial expressions

gesture

Written

Photos

Emails

TextsSymbols

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What are the 4 parts of communicationPerson/ Interaction

Reason/ WhyWay/ How

Understanding

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What are the pre-requisite skillsattention skills,visual skills,

auditory skills,tactile skills,imitation skills,cognitive skills, and

referential knowledge

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What do we need to communicate

Have ideas

Understand

meaning

Understand

grammar

Understand

Words

“semantics

”

Remember/

memory

Listen/hear

Interpret

non-verbals

Attend

and look

Self

monitor

Follow

rules of

conversation

Use body

language

Speak

fluently

Articulate

sounds

Co-ordinate

Speech

muscles

Choose

sounds

Sentence

structure

Choose

words

EXPRESSION

Reception

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Delay versus DisorderA child can have a language delay but be developing appropriately in other aspects of their development

A child can be delayed across all areas of their development including language developmentIn some cases children have specific difficulties in some or all areas of receptive and expressive language. This is

now known

as Developmental Language Disorder (DLD)

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SPEECH SOUND DEVELOPMENT

VERBAL CONVERSATIONS

UNDERSTANDING AND USING PHRASES AND SENTENCES

SIMPLE CONVERSATIONS

USING SINGLE WORDS

VERBAL UNDERSTANDING

POINTING

GESTURE

SITUATIONAL UNDERSTANDING

TURN-TAKING

BABBLE

VOCALISATION

HEARING

LOOKING

LISTENING

ATTENTION PlayMotivationMotor skillsEnvironmentParent/child interactionStimulationNurture/Trauma

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Group discussionThink about a child you have recently seen where you have had a concern about all or aspects of their communication. Using the building blocks indicate how they were functioning in each of the areas starting from the bottom.

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What have the experts said about language?Naom Chomsky – “The Human Brain has a naturally built in template for the learning of language”

Lev Vygotsky – “Language development is dependant on the interaction with others”

BF Skinner – “language learning is pushed through a reward-response system”

Jean Piaget – “Language develops instrinsically with other cognitive skills such as processing, memory, reasoning, empathy and inference”.

Howard Gardener – “language deficiency should not be used as a defining measure of intelligence but as one of many types of intelligence”

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By six months...

Babies communicate from day one. As they develop, they begin to watch the adults aroundthem and start making noises. They will communicate with adults by watching their faces

and might try to copy what they do.

Being able to copy is important for young babies –

it is how they learn.By six months, babies will usually:make sounds, like cooing, gurgling and babbling, to themselves and with other people

make noises to get your attention

watch your face when you talk to them

get excited when they hear voices coming, maybe by kicking or waving their arms or

making noises

smile and laugh when other people smile and laugh

make sounds back when talked to

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By one year...

Babies communicate in more ways now – making noises, pointing and looking to get your attention

. They start to understand routines, simple words and activities.

By one year

, babies will usually:make talking noises - babble strings of sounds, like ‘ma-ma-ma’, ‘ba-ba-ba’point and look at you to get your attention

many, though not all 1 year olds, will be saying their first words and they may also

use

gestures

start to understand words like ‘bye-bye’ and ‘up’ especially when a gesture is used at the

same time

recognise the names of familiar objects, things like ‘cup’ and ‘bowl’, ‘teddy’ and ‘mummy’

look

at you when you speak or

when they hear their name called

take turns in ‘conversations’, babbling back to an adult

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By 18 months...

This is a very exciting time – babies will be starting to talk now. Not everyone will understandbut they are having a good try at saying a handful of words.

By 18 months

, babies will usually: be talking but not all will be talking and this is ok.

Most importantly they will understand some simple words andshort phrases. These are usually things they hear a lot during the day, such as

‘

coat on

’,

‘drink

’, ‘

shoes’,

‘

bus’,

‘

in your

buggy’, ‘dinner time’, ‘all gone’Recognise and point to familiar objects when you ask themenjoy games like ‘peek-a-boo’ and ‘pata-cake’ and toys that make a noise –

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By two years...

Their understanding of words and phrases grows really quickly during thistime.

They often understand much more than they say. This can result in frustration

when they don’t get their message across.

By two years, toddlers will usually:understand between 200 and 500 words

use 50 or more single words like ‘juice’, ‘car’, ‘biscuit’ though some children may not be using many words and this is not in itself a cause for concern

be starting to put short sentences together with two to three words, such as “more juice” or “bye-bye daddy”

be asking simple questions such as “what that?”, “who that?”. They might do this quite a lot!

understand simple questions and instructions like

“where’s baby”, “go get your coat”, “mummy’s turn”

enjoy pretend play with their toys, such as feeding dolly

or pretending to drive a car, usually making noises and

talking while playing

become very frustrated when they cannot get their

message across. This is one reason for toddler tantrums!

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By three years...

By three years, children will usually:They will use different types of words to do different things, e.g.

to describe what things look like – ‘big’, ‘soft’

where they are – ‘under’, ‘on’

what they are for – ‘eating’, ‘playing’that say who they are – ‘me’to describe how many - ‘lots’

refer to something that has happened in the past

put 4 or 5 words together to make short sentences, such as “me want more juice”,

ask lots of questions

have clearer speech, although they will still have some immaturities. people who know them can understand them better.

listen to and remember simple stories with pictures

understand longer instructions, such as “put on your coat and get your bag” or “where’s mummy’s coat?”

understand simple ‘who’, ‘what’ and ‘where’ questions though not all do

play more with other children and join in with play

play more complex imaginative games

be able to have a proper conversation, though they may flit around the topic a bit and be

difficult to follow at timesbe able to recognise how other people feel and will try to do something about it e.g “Ah,Josie sad. She need a hug

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By four years….

ask lots of questions using words like ‘what’, ‘where’ and ‘why’

be able to answer questions about ‘why’ something has happened

use longer sentences and link sentences together, e.g. “I had pizza for tea

and thenI played in the garden”describe events that have already happened, e.g. “We got dressed up and we went

to the hall and singed songs. All the mummies and daddies did watch”

have mostly clear speech, though can continue to have difficulties with some sounds

number of sounds – for example ‘r’ – as in rabbit, ‘l’ – as in letter, ‘th’

as in thumb, ‘sh’ as in show, and ‘j’ as in jam

listen to longer stories and answer questions about a story they have just heard

understand and often use colour, number and time related words, for example,

‘red’ car, ‘three’ fingers

enjoy make-believe play

start to like simple jokes – though often their own jokes make little sense!

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By 5 years…take turns in much longer conversations

use sentences that are well formed, for example, “I had spaghetti for tea at Jamilia’s house”

be learning more words all the time as well as thinking more about the meanings of words, such as describing the meaning of simple words or asking

what a new word means

be able to re-tell short stories they have heard in roughly the right order and using language that makes it sound like a storyuse most speech sounds. However, they may have some difficulties with more difficult words such as ‘scribble’ or ‘elephant’ and some speech sounds may still be difficult

enjoy listening to stories, songs and rhymes and will start to make up

their own ask relevant questions or make relevant comments in relation to what they have

heard

understand spoken instructions without stopping what they are doing to look at the speaker

understand more complicated language such as ‘first’, ‘last’, ‘might’, ‘maybe’, ‘above’ and ‘in between’

understand words that describe sequences such as “

first

we are going to the shop,

next

we will play in the park”

choose their own friendsuse talk to take on different roles in imaginative play, to interact and negotiate with people and to have longer conversationsuse talk to help work out problems and organise thinking and activities

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Stammering/stuttering

Some children, when they are learning to talk, can stumble over words/pause and start again etc. This can

sound like a

stammer/stutter.

Between the ages of two and five years it is normal for a child to repeat words and phrases or hesitate while they are thinking of what they are trying to say. Many children will become more fluent as they get older but others can continue to get stuck and find talking difficult.

 

It is important to seek early intervention for these children and their families.

Factors that contribute to increased risk of persistent stammering are;

Positive family history

Child awareness and/or signs of frustration

Child has been stammering for more than 6 months

Difficulties with speech and language development

High levels of

parental anxiety

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DiscussionFor a recent case you have dealt

with, what pre-requisites were not

in place to develop language/communication….

How did this present itself (using the

building blocks in slide 8)How did this inform your formulation?What intervention did you choose as a result?

What would you change on reflection?

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Gathering information as part of an assessment where communication is a concern

Case history from parents is crucial

Background information and family circumstances and any trauma or gaps in child/parent interaction

Birth history

Medical historyHow language has developedOther aspects of development particularly play, self help and attention.

Observe the child playing and interacting with others both family and peers.

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Questions

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